SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Retooling an Osteoporosis Prevention Program to Serve
Low-Income Populations: A Practical Guide to Bone Health

We modified an existing osteoporosis prevention program to
address the needs of low-income consumers in Michigan and
conducted a pilot test to assess the program’s
effectiveness.

Building on previously collected focus group data from
consumers and educators, we surveyed eight educators with the
Michigan State University Extension (MSUE) to help identify
barriers encountered delivering an educational osteoporosis
prevention program to low-income constituents. The educators recommended
program content changes that placed more emphasis on practical
information relating to food choices, nutrition, and physical
activity. Registered dietitians and staff representing the
Michigan Nutrition Network, United Dairy Industry, and the
Michigan Department of Community Health developed new
material. The resulting program, A Practical Guide to Bone
Health, was designed as a 45-minute presentation available
in either a flip-chart or PowerPoint format. The content
emphasized physical activity, diet quality, and the importance of
calcium and vitamin D. A shopping section guided consumers to
better food choices. The program also encouraged change in diet
and physical activities. A statewide steering committee reviewed
the program before a final field test.

We conducted the program at four sites, one urban and three
rural, selected by MSUE educators who reach low-income
populations. Participants completed pre-tests and post-tests
assessing basic knowledge and intent to change behavior.
Educators documented program location, number of participants,
and audience income level.

A total of 46 people participated in the program. Participants
were primarily between the ages of 18 and 44 years (75%), white
(93%), and female (79%); at three of four sites, participants
were predominantly low-income. A total of 43 participants
completed both the pre-test and the post-test (93%). Of those who
did not have perfect scores on the knowledge pretest, 73%
increased their scores following the session. Prior to the
program, 28% reported inadequate calcium intake and 30% reported
inadequate physical activity. At post-test, 50% of those with low
calcium intake indicated intent to eat three or more servings of
calcium-rich foods. Likewise, 62% of those with low activity
levels reported intent to increase physical activity to at least
30 minutes three times a week. An additional 13% indicated intent
to increase activity to 30 minutes five times a week.

Collaboration among public health practitioners resulted in an
easy-to-use and effective osteoporosis prevention program
directed toward the needs of low-income populations.

The opinions expressed by authors contributing to this
journal do not necessarily reflect the opinions of the U.S. Department of Health
and Human Services, the Public Health Service, the Centers for Disease Control and
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